Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
This role will provide support to RCM billing efforts for secondary medical claims which include the following responsibilities below. Once the new hire is at 90 days, the expectation of productivity is submitting 30 claims daily with an average goal to work 630 claims per month.1. Submit secondary medical claims accurately per payer nuances accordingly.2. Ensure quality claim submissions to achieve clean claim rate of 99% or higher. 3. Maintains/Works on different billing claims platforms such as D365 and CPR+ to complete claim submissions.4. As needed, conducts training and knowledge updates to support operations in skilling up all billers.
This position is full-time (40 hours/week). Employees are required to work our normal business hours of 8:00am – 5:00pm CST, Monday – Friday. It may be necessary, given the business need, to work occasional overtime or weekends.
This will be on-the-job training and 1-on-1 shadowing with supervisor & peer. The hours during training will be an 8-hour shift between 7:00am to 7:00pm CST, Monday – Friday. Training will be conducted virtually from your home.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Create invoices that are accurately generated and submitted on a timely basis, applying knowledge of medical coding, pricing reviews and ability to understand payor contracts/fee schedules to ensure clean claims are created to avoid denials and adjustments
Complete account reviews/correction requests submitted by other departments within established turnaround times.
Review policies, systems, methods and procedures for the effective management and control of the premium billing function
Identify any trends or billing inaccuracies with investigation and resolution, escalating to Supervisor/Manager when assistance is needed
Collaborate with internal and external departments to resolve complex billing issues
Meet performance requirements following billing department’s metrics
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
High School Diploma / GED OR equivalent work experience
Must be 18 years of age OR Older
1+ years of Home Infusion Billing or Pharmacy Billing experience
Proficiency using Windows computer applications, including the ability to navigate multiple programs and learn new and complex computer system applications
Ability to work a 40-hour schedule within the operating hours of the site
Ability to attend training between 7:00am to 7:00pm CST, Monday – Friday
Ability to work our normal business hours of 8:00am – 5:00pm CST, Monday – Friday. It may be necessary, given the business need, to work occasional overtime or weekends
Preferred Qualifications:
1+ years of experience in a related environment (i.e., medical office, pharmacy, hospital, etc.)
Knowledge of HCFA 1500/UB-04 forms
Specialty medication billing experience
Previous experience in billing or collections
Knowledge working within Clearinghouse Applications
Knowledge of NDC, ICD-10, and HIPAA
Home infusion billing or DME (Durable medical equipment)
Telecommuting Requirements:
Ability to keep all company sensitive documents secure (if applicable)
Required to have a dedicated work area established that is separated from other living areas and provides information privacy
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
The hourly range for this role is $16.88 to $33.22 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.
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UnitedHealth Group
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